Page 1395 - Saunders Comprehensive Review For NCLEX-RN

because of removal of parathyroid
tissue

2. Assessment

a. Hypocalcemia and hyperphosphatemia
b. Numbness and tingling in the face
c. Muscle cramps and cramps in the
abdomen or in the extremities
d. Positive Trousseau’s sign or
Chvostek’s sign
e. Signs of overt tetany, such as
bronchospasm, laryngospasm,
carpopedal spasm, dysphagia,
photophobia, cardiac dysrhythmias,
seizures
f. Hypotension
g. Anxiety, irritability, depression

3. Interventions

a. Monitor vital signs.
b. Monitor for signs of hypocalcemia and
tetany.
c. Initiate seizure precautions.
d. Place a tracheotomy set, oxygen, and
suctioning equipment at the bedside.
e. Prepare to administer calcium
gluconate intravenously for
hypocalcemia.
f. Provide a high-calcium, low-
phosphorus diet.
g. Instruct the client in the administration
of calcium supplements as prescribed.
h. Instruct the client in the administration
of vitamin D supplements as
prescribed; vitamin D enhances the
absorption of calcium from the
gastrointestinal (GI) tract.
i. Instruct the client in the use of thiazide
diuretics if prescribed, to protect the
kidney if vitamin D is also taken.
j. Instruct the client in the administration
of phosphate binders as prescribed to
promote the excretion of phosphate
through the GI tract.
k. Instruct the client to wear a MedicAlert
bracelet.
B. Hyperparathyroidism

1395